Publications by authors named "Susan Jebb"

Article Synopsis
  • Weight loss significantly improves the chances of achieving remission for people with type 2 diabetes, prompting a study to enhance weight management services based on experiences from individuals with diabetes and health coaches.
  • Researchers conducted qualitative interviews with 37 adults with type 2 diabetes and 16 health coaches in England, identifying four key themes regarding their diabetes care experiences: coping with diagnosis, insightful moments, maintaining change, and gaining confidence.
  • Findings highlight a disconnect between the rigid care models described by coaches and the diverse, individualized experiences of patients, emphasizing the need for more flexible and responsive diabetes management services to boost engagement and adherence.
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Objectives: There is evidence that general practitioners (GPs) can increase the uptake of weight management programmes that enhance weight loss compared with self-directed efforts, but the rate at which they do so is unclear. This study examined the prevalence of weight control efforts and practices, the reported frequency and impact of receipt of GP advice on weight loss attempts and perceptions of the appropriateness of health professionals delivering weight loss advice.

Design: A nationally representative cross-sectional survey.

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Guidelines specify that clinicians should support patients living with obesity by referring to weight management programmes (WMPs), but clinicians do so infrequently. To provide additional support to patients living with obesity and weight-related conditions, the UK government instated the National Enhanced Service (NES) for weight management in England, including a reimbursement to general practices for referring eligible patients to WMPs. To assess the impact of the NES on conversations regarding weight and relevant behavioural risk factors in primary care consultations we recruited 11 medical practices in England where the NES was operating and six comparator practices from Scotland and Wales where the NES was not implemented.

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Article Synopsis
  • Polycystic ovary syndrome (PCOS) is prevalent among women of reproductive age and often linked to obesity, with clinical guidelines recommending weight loss to manage symptoms, although its effectiveness remains uncertain.* -
  • This study aimed to assess the impact of weight loss interventions on various clinical features of PCOS against standard care, using a systematic review of randomized controlled trials.* -
  • Results indicated that weight loss interventions led to significant improvements in insulin resistance, hormone levels, and menstrual regularity, while showing no significant negative effects on participants.*
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Article Synopsis
  • * The study found that a decrease in serum zonulin levels (a marker of intestinal permeability) was correlated with both weight loss and a reduction in liver fat, indicating improved metabolic health.
  • * While initial changes in gut microbiota and short-chain fatty acids (SCFAs) occurred at 12 weeks, these effects did not persist at 24 weeks, suggesting that longer-term benefits in MASH may not be linked to sustained changes in the gut microbiome.
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Background: As rates of obesity and overweight continue to increase in the UK, calorie labels have been introduced on menus as a policy option to provide information to consumers on the energy content of foods and to enable informed choices. This study tested whether the addition of calorie labels to items in a simulated food delivery platform may reduce the energy content of items selected.

Methods: UK adults (n = 8,780) who used food delivery platforms were asked to use the simulated platform as they would in real life to order a meal for themselves.

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Providing consumers with product-specific environmental impact information for food products (ecolabels) may promote more sustainable purchasing, needed to meet global environmental targets. This UK study (N = 1051 participants) investigated the effectiveness of different ecolabels using an experimental online supermarket platform, comparing three labels against control (no label). Significant reductions were found in the environmental impact score (EIS) for all labels compared to control (labels presented: values for four environmental indicators [-3.

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Background: Previous small studies investigating health-related quality of life (HRQoL) following bariatric surgery have demonstrated heterogenous effects. This study aimed to use National Bariatric Surgery Registry (NBSR) records to investigate the relationship between weight and HRQoL in people undergoing bariatric surgery in the UK.

Materials And Methods: In this observational study using United Kingdom National Bariatric Surgery Registry (NBSR) records between 1st June 2017 and 23rd November 2022, patients undergoing primary bariatric surgery with one baseline and at least one follow-up visit within 1 year from surgery were eligible for inclusion.

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Background: Diet-disease association studies increasingly use dietary patterns (DP) to account for the complexity of the exposure. We assessed if a DP associated with type 2 diabetes mellitus, cardiovascular disease, and all-cause mortality is also associated with colorectal cancer.

Methods: We used reduced rank regression on 24-hour recall data to identify DPs, explaining the maximum variation in four nutrient-response variables: energy density, saturated fatty acids, free sugars, and fiber density.

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Background: On 6 April 2022, legislation came into effect in England requiring calorie labels to be applied to food items on menus of larger food businesses. This study aimed to assess the impact of calorie labelling on (a) food purchased and (b) energy content of menu options in worksite cafeterias.

Methods: Product-level sales data and energy content of available items was obtained from 142 worksite cafeterias from January 2022-October 2022.

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Background: Randomised controlled trials have shown that total diet replacement (TDR) can lead to remission of type 2 diabetes. In 2019, the English National Health Service (NHS) committed to establishing a TDR-based interventional programme delivered at scale within real-world environments; development followed of the NHS Type 2 Diabetes Path to Remission (T2DR) programme, a 12-month behavioural intervention to support weight loss involving an initial 3-month period of TDR. We assessed remission of type 2 diabetes for programme participants.

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Background: Digitally delivered weight loss programmes can provide a convenient, potentially cheaper, and scalable treatment option for people who may need to lose weight. However, outcomes are often inferior to in-person interventions in the long-term. This trial will use principles from the Multiphase Optimisation Strategy (MOST) framework to test whether it can enhance the effectiveness of a commercial digital behavioural weight loss programme.

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Objective: To evaluate the effectiveness of behavioural interventions that include motivational interviewing on physical activity outcomes in adults.

Design: Systematic review and meta-analysis.

Study Selection: A search of seven databases for randomised controlled trials published from inception to 1 March 2023 comparing a behavioural intervention including motivational interviewing with a comparator without motivational interviewing on physical activity outcomes in adults.

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Background: The period between cancer diagnosis and surgery presents an opportunity for trials to assess the feasibility of behaviour change interventions. However, this can be a worrying time for patients and may hinder recruitment. We describe the perspectives of patients with excess weight awaiting colorectal cancer surgery about their recruitment into a randomised trial of a prehabilitation weight loss intervention.

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Food purchasing behaviours are shaped by the choices available to shoppers and the way they are offered for sale. This study tested whether prominent positioning of more sustainable food items online and increasing their relative availability might reduce the environmental impact of foods selected in a 2x2 (availability x position) factorial randomised controlled trial. Participants (n = 1179) selected items in a shopping task in an experimental online supermarket.

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Background: Dietary changes are necessary to improve population health and meet environmental sustainability targets. Here we analyse the impact of promotional activities implemented in UK supermarkets on purchases of healthier and more sustainable foods.

Methods: Three natural experiments examined the impact of promotional activities on sales of a) no-added-sugar (NAS) plant-based milk (in 199 stores), b) products promoted during 'Veganuary' (in 96 stores), and c) seasonal fruit (in 100 non-randomised intervention and 100 matched control stores).

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Article Synopsis
  • Excess weight significantly increases both hospital stay duration and likelihood of ICU admission for COVID-19 patients compared to those with a normal BMI.
  • In a study of over 57,000 COVID-19 patients in England, those with obesity experienced longer hospitalizations and higher treatment costs, averaging £2736 more than those with a normal BMI.
  • The findings highlight the need for improved national hospital resource allocation and potential healthcare policies targeting individuals with higher BMI to manage COVID-19 impacts better.
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Background: Physical activity (PA) interventions have an encouraging role in gestational diabetes mellitus (GDM) management. Digital technologies can potentially be used at scale to support PA. The aim of this study was to assess the feasibility and acceptability of + Stay-Active: a complex intervention which combines motivational interviewing with a smartphone application to promote PA levels in women with GDM.

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Aim: To investigate the association of gestational diabetes mellitus (GDM) with premature mortality and cardiovascular (CVD) outcomes and risk factors.

Materials And Methods: Parous women recruited to the UK Biobank cohort during 2006-2010 were followed up from their first delivery until 31 October 2021. The data were linked to Hospital Episode Statistics and mortality registries.

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Background: One-third of people with depression do not respond to antidepressants, and, after two adequate courses of antidepressants, are classified as having treatment-resistant depression (TRD). Some case reports suggest that ketogenic diets (KDs) may improve some mental illnesses, and preclinical data indicate that KDs can influence brain reward signalling, anhedonia, cortisol, and gut microbiome which are associated with depression. To date, no trials have examined the clinical effect of a KD on TRD.

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Objective: The study objective was to assess participant weight change for the English National Health Service (NHS) Digital Weight Management Programme, the first such digital intervention to achieve population coverage.

Methods: A service evaluation was used to assess intervention effectiveness for adults with obesity and a diagnosis of hypertension and/or diabetes, between April 2021 and March 2022, using prospectively collected, national service-level data in England.

Results: Of the 63,937 referrals made from general practices, within the time period, 31,861 (50%) chose to take up the 12-week Programme.

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A reduction in meat consumption is necessary to mitigate negative impacts of climate change and adverse health outcomes. The UK has an increasingly multi-ethnic population, yet there is little research on meat consumption habits and attitudes among ethnic groups in the UK. We ran a survey (N = 1014) with quota samples for ethnic groups and analyzed attitudes, behaviors and norm perceptions of White, South Asian and Black British respondents.

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